Abstract
The purpose of this study was to determine the number and characteristics of US State Registrars of Vital Statistics (Vital Registrars) and State Systems Development Initiative (SSDI) Coordinators that link birth certificate and hospital discharge data as well as using linkage processes. Vital Registrars and SSDI Coordinators in all 52 vital records jurisdictions (50 states, District of Columbia, and New York City) were asked to complete a 41-question survey. We examined frequency distributions among completed surveys using SAS 9.3. The response rate was 100% (N = 52) for Vital Registrars and 96% (N = 50) for SSDI Coordinators. Nearly half of Vital Registrars (n = 22) and SSDI Coordinators (n = 23) reported that their jurisdiction linked birth certificate and hospital discharge records at least once in the last 4 years. Among those who link, the majority of Vital Registrars (77.3%) and SSDI Coordinators (82.6) link both maternal and infant hospital discharge records to the birth certificate. Of those who do not link, 43% of the Vital Registrars and 55% of SSDI Coordinators reported an interest in linking birth certificate and hospital discharge data. Reasons for not linking included lack of staff time, inability to access raw data, high cost, and unavailability of personal identifiers to link the two sources. Results of our analysis provide a national perspective on data linkage practices in the US. Our findings can be used to promote further data linkages, facilitate sharing of data and linkage methodologies, and identify uses of the resulting linked data.
Highlights
Public health agencies and researchers rely heavily on birth certificate and hospital discharge data for national and local surveillance and research activities related to pregnancy complications, risk behaviors, and neonatal outcomes [1, 2]
Our survey demonstrated that linking birth certificate and hospital discharge data is feasible and that supporting linkage activities is needed to overcome barriers and challenges in building and strengthening capacity for all jurisdictions
Results from analyses using these linked administrative data can be used at state and national levels to inform maternal and child health programs, improve public health infrastructure including up-to-date data and information systems to respond to public health needs, and monitor trends in pregnancy conditions, risk behaviors, and perinatal outcomes [7,8,9]
Summary
Public health agencies and researchers rely heavily on birth certificate and hospital discharge data for national and local surveillance and research activities related to pregnancy complications, risk behaviors, and neonatal outcomes [1, 2]. These data sources are large, accessible, and available for most in-hospital births in the United States. Previous studies have found that combining these two databases provides a wider range of data and a more accurate source for identifying maternal diagnoses than a single source alone [3, 4] These linked data are a feasible source for examining contributions of known modifiable risk factors to pregnancy complications [5, 6]. Results from analyses using these linked administrative data can be used at state and national levels to inform maternal and child health programs, improve public health infrastructure including up-to-date data and information systems to respond to public health needs, and monitor trends in pregnancy conditions, risk behaviors, and perinatal outcomes [7,8,9]
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